Virtual reality deep breathing and guided relaxation training in stress relief during needle procedures in paediatric patients: A feasibility study

Background The incidence and disease burden of stress-related symptoms in children have increased in recent years. Relaxation techniques are beneficial when treating young people experiencing stress, anxiety and fear. Thus, new nonpharmacological treatment approaches, such as mindfulness-based methods for paediatric patients, must be introduced. Methods This feasibility study compared virtual reality (VR)-based deep breathing and VR-guided relaxation exercises as stress relief options for paediatric patients. This study included 41 children aged 8–12 years who underwent a needle procedure in a hospital setting. Responses in the autonomic nervous system were monitored using heart rate variability (HRV) analysis. Results VR-based deep breathing exercise lowered the respiratory rate more than the VR-guided relaxation exercise. HRV measurements taken 1 minute before and after the exercises showed significant activation of the parasympathetic nervous system (PNS) during training, with the VR-guided relaxation exercise creating a slightly more intense response . In the 6-minute HRV analysis, no significant differences were seen between the exercises. These findings indicate that both exercises affect the parasympathetic nervous system, with no significant difference between the exercises. Conclusions Both types of VR exercises seem to be equally well-received, feasible and promising nonpharmacological treatment options in paediatric clinical practice. VR-based deep breathing and VR-guided relaxation training showed great potential as stress relief techniques when dealing with paediatric patients undergoing needle procedures. Trial registration ISRCTN12712970 was retrospectively registered on 23rd May 2025.